Nuutinen J, Kuikka J, Roivainen R, Vanninen E, Sivenius J
Department of Neurology, Kuopio University Hospital, Finland.
Nucl Med Commun. 2000 May;21(5):425-9. doi: 10.1097/00006231-200005000-00003.
The size and severity of perfusion defects in acute cerebral ischaemia on single photon emission tomographic (SPET) images may provide useful information regarding long-term (> 3 month) stroke outcome. A decreased predictive value has been reported with delayed SPET more than 24 h after stroke onset. We examined 20 patients with acute middle cerebral artery (MCA) infarctions using serial 99Tcm-ECD or 99Tcm-HMPAO SPET (SPET 1 one day and SPET 2 three days after stroke onset). Neurological (NIH, SSS) and functional (Barthel, Rankin) scores were calculated simultaneously and 3 months poststroke. The two SPET scans correlated equally well with the severity of functional and neurological deficits evaluated 3 months after stroke onset. In comparison to clinical assessment, the prognostic value of SPET was relatively better on the first day than the third day. Crossed cerebellar diaschisis correlated with early SPET deficits, but did not predict functional outcome. Our results suggest that SPET, either with 99Tcm-ECD or 99Tcm-HMPAO, can be used to predict stroke outcome in acute MCA infarction up to 72 h poststroke without significant interference from luxury perfusion.
单光子发射断层扫描（SPET）图像上急性脑缺血灌注缺损的大小和严重程度可能为长期（>3个月）卒中预后提供有用信息。据报道，卒中发作后超过24小时进行延迟SPET检查时预测价值会降低。我们使用连续的99锝-乙撑半胱氨酸二聚体（99Tcm-ECD）或99锝-六甲基丙二胺肟（99Tcm-HMPAO）SPET（卒中发作后1天的SPET 1和3天的SPET 2）对20例急性大脑中动脉（MCA）梗死患者进行了检查。同时计算神经功能（美国国立卫生研究院卒中量表、斯堪的纳维亚卒中量表）和功能（巴氏指数、Rankin量表）评分，并在卒中后3个月进行计算。两次SPET扫描与卒中发作后3个月评估的功能和神经功能缺损严重程度的相关性同样良好。与临床评估相比，SPET的预后价值在第一天比第三天相对更好。交叉性小脑失联络与早期SPET缺损相关，但不能预测功能结局。我们的结果表明，无论是使用99Tcm-ECD还是99Tcm-HMPAO的SPET，都可用于预测急性MCA梗死在卒中后72小时内的卒中预后，而不会受到过度灌注的显著干扰。
